HIV and ID Observations

March 8th, 2020

As Testing Ramps Up, Diagnoses of Coronavirus Disease in the U.S. Will Soon Increase Substantially — How Will We Respond?

Brace yourself. As coronavirus disease (COVID-19) occurs at multiple locations around the United States, the number of confirmed cases here is about to increase big time. There are two reasons: New infections More testing Believe it or not, despite statements by certain politicians, COVID-19 tests still cannot be ordered by any clinician who believes it should be […]

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March 6th, 2020

CROI 2020 Will Be a “Virtual Meeting” After All — Plus, What Scares Me (and Doesn’t) About Coronavirus

This just in: BREAKING NEWS: #CROI2020 will be a virtual meeting this year! Thanks to @IAS_USA @DonnaJacobsen and all CROI leadership for wrestling with this difficult decision and putting public health first. https://t.co/KPmJ66x7GL — Melanie Thompson (@drmt) March 6, 2020 If you’re a frequent reader of this blog, you might have read here just minutes ago that […]

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February 25th, 2020

First Week on Service, with One-a-Day ID Learning Units

There is almost always something to be learned from every new patient. It might be buried somewhere in the history, or the physical, or the lab tests, or the micro, or the imaging — but the odds are excellent that, with enough rumination, you’ll find it. I can’t remember now who taught me this important fact, or […]

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February 17th, 2020

Short-Course Treatment of Latent TB, Combination Therapy for Staph Bacteremia, Adult Vaccine Guidelines, Novel Antifungals, and Others — A Non-COVID-19 ID Link-o-Rama

There’s so much out there right now on COVID-19 (the disease) and SARS-CoV-2 (the virus) that the other ID news gets crowded out. Which means it’s time for non-COVID-19 ID/HIV Link-o-Rama! I haven’t done one of these in a while, so there’s plenty of material in the vaults yearning to be free. The CDC now recommends short-course, […]

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February 9th, 2020

Should Medical Subspecialists Attend on the General Medical Service?

As I’ve written about many times on this site, one of the highlights of the year for me is when I attend on the medical service — something I’ve been doing pretty much forever. There’s a wonderful learning exchange that goes on, with my knowledge of ID being repaid in kind by the others on the […]

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February 2nd, 2020

A Coronavirus ID Link-o-Rama, Because I’m Not Watching the Super Bowl

With so much of the ID-related news out there dominated by the novel coronavirus (2019-nCoV, hard to type) outbreak, it seems appropriate to collect some of the more interesting or useful findings in this busy past week. Think of it as an ID Link-o-Rama — Special Novel Coronavirus Edition. As with last week’s post, an important caveat […]

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January 26th, 2020

Uncertainties Notwithstanding, Pace of Scientific Discovery in Coronavirus Outbreak Is Breathtakingly, Impressively Fast

The current novel coronavirus outbreak due to 2019-nCoV and SARS from 2002–3 share many features, including: Both are coronaviruses, genetically distinct from those that had caused infection in humans previously (most of which led to cold-like illnesses) First cases recognized in China, with subsequent international spread Source an animal reservoir — likely bats for both of […]

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January 20th, 2020

Telemedicine, eConsults, and Other Remote ID Clinical Services Make So Much Sense — Why Isn’t Everyone Doing it?

The ID group at Mayo Clinic just published a small but important study on the use of remote ID telemedicine consults for hospitals that have no ID services on-site. The consults were “asynchronous”, meaning that the ID consultants at the main hospital finished them within 24 hours — they didn’t have to respond immediately. Importantly, all […]

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January 13th, 2020

Diagnostic Tests for Syphilis Continue to Perplex Even the Experts: An Unanswerable Question in Infectious Diseases

Here’s a tricky clinical scenario: An elderly person with cognitive decline or some other non-specific neurologic symptom sees a clinician. Clinician sends a syphilis screen with a T. pallidum enzyme immunoassay (TP-EIA), which returns positive. Lab runs a confirmatory test — a T. pallidum particle agglutination test (TP-PA), or similar, which also returns positive. The lab […]

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January 6th, 2020

The Decade’s Top 10 Biggest Changes to ID Clinical Practice

Here’s a question for you ID and HIV and other clinicians out there as you start 2020 — what are the 10 biggest changes to ID/HIV clinical practice over the past 10 years? Not necessarily what are the biggest stories or biggest advances (though they certainly are eligible) — but more specifically, when you are seeing […]

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